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1982, 01-28 Permit: 82A-676 WoodstovePLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES JOB ADDRESS . 19403 4th Ave. LEGAL DESCRIPTION — SEE ATTACHED LOT BLOCK SUBDIVISION 3. OWNER George Anderson PHONE 926-6597 PARC NUM.3ER/S ADDRESS . 19403 4th Ave. ZIP 99016 Actual Set Backs in Feet North 'South East West CONTRACTOR Valley Fireplace Inc. PHONE 922-2780 Size of Parcel Zone Classification ADDRESS E. 16610 Sprague Ave. ZIP 99037 Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. DESIGNER Contractor License No. 5. ADDRESS VA LL !SF 626 01131 PHONE Building lding Area in Sq. Ft. ZIP Main Floor I Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK ❑ NEW O BLD. O ALT. O PLMB. O AD'N. O MECH. O RPL. O M.H. O MVE. O POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK Install "Blaze Princess" woodstove 8. into existing prefabricatedhi cmney. VALUATION SOURCE GAS ELECTRIC WATER OF 9. UTILITIES, Enum. Dist. I Location (Area) SEWER Ownership Public ❑ Private 0 USE CODE I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance -of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Enginee Utilities Plans Examiner SEPA Checklist Building chnici SIGNATURE OF APPLICANT SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL PERMIT NUMBER 7@ 04* *2000 * 2000 * 2000'6 A *0.00 67.52 01-28-82 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. O1;-2&-8'2` 67,65 *2QOOa1 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL